My American Idol eggs

“What a beautiful uterus,” says Shannon the technician. “All dressed up in her Sunday best.”

Yep, that’s my uterus – a real girly girl, getting all dolled up before trips to the fertility clinic. I tell her it’s no big deal, just wear sweat pants like me and my lulu’s – but no, she likes turning heads when she leaves the house.

So my uterus is on the display screen and looking good. Having established that ( and having taken a picture with her fancy machine) the technician takes a short break in her ultra sound scanning so I can go to the washroom. One hour before the appointment I drank about half a litre of water. Zsolt was pushing for the full litre, “Come on, drink more!” and I pushed back, saying, “I’m full! I can’t manage another drop!” What I didn’t mention was that I was mainly full because (only two minutes before) I’d stuffed two cookies down my throat in a bit of a ‘need a snack, oh, there’s a snack’ quick-fix indulgence. But nevertheless, I drank the minimum required amount of liquid one hour before my ultra sound, which meant by the time we arrived at the fertility clinic and were escorted in for the scan, I was bursting to use the washroom.

A minute later and I’m back in the scan room, relieved of holding it in, and with a sheet wrapped around my lower body (trousers and pants removed) as the technician has me sit back on the table.

Earlier, as Zsolt and I waited to be called for the test, Shannon (the technician) came out into the waiting lounge and asked, “Catherine?” To which I replied, “That’s me!” and hurried over to her side. She then asked, “aren’t you taking him with you?” So Zsolt, who is used to not accompanying me on my tests because generally speaking, nurses at the hospitals here in Ottawa are not keen on a second person in the room, put away the Playbook and joined us for the scanning. Today he was allowed to hold my hand as Shannon investigated the status of my ovaries, and I’m really thankful for that. It means we both know more about the situation.

(I’m strong in my belief that a patient ought to be allowed a source of support during tests and procedures. Even if they are sitting across the room, it so helps to have a loved one nearby during those challenging moments.)

So I’m on the table, and we’re getting down to the real stuff here. In goes the ultra sound wand. (In where? You guess.) After a few uncomfortable attempts to capture my left ovary, where she pushed down on my abdomen and prods upwards with the wand, we have a clear picture.

Basically, we are examining my ovaries today to learn about the eggs. Now, Shannon is not a doctor, so the results of my scan cannot be 100% confirmed until someone trained for years up on years in ultra sounding has examined the images, but she does explain what she sees.

“Basically your eggs are like contestants for American Idol. There are so many, that you can’t see the individual people (i.e. eggs) on a scan. But every month there are try outs, and the people who succeed for those try outs (i.e. eggs that try to ovulate) and get through to the competition are given costumes and makeovers – and then we can see them. (i.e. the follicles change in a way that makes them apparent in an ultra sound).”

So, looking at my left ovary . . . not too many contestants made it to the try outs. The blob that represents my ovary is small, and she counts only three follicles. That is a low number. (But better than zero, in my opinion.)

Onto Ms Right. Moving to the other side, with more compression and squeezing of my abdomen, she takes a picture of my right ovary and then explains what she sees.

“See how it’s so much larger?”

And it is – it’s like three times larger than my left ovary. Apparently, according to Shannon, the left ovary often takes the hit when it comes to declining fertility. Mine certainly has. But in my right there are seven follicles. That’s not horrible.

Apparently, the minimum number of follicles (eggs that made the competition) the doctors are happy to see in women when combining numbers from both left and right is eleven. Eleven. My combined number was ten. Ten.

Therefore, I have low fertility levels . . . but . . . well, ten is almost eleven, right?

“You might have to get on that earlier than other women,” she suggests. What Shannon means is, I ought to be trying for a baby now as opposed to later.

Which is more easily said than done, considering I’m only one year out of treatment. But Zsolt and I have a plan, and it involves waiting at least another year before trying. And in the meanwhile, I’m on tamoxifen and trying to keep this body healthy.

The truth is, there are more tests they could run, more scans they can take – because knowing the state of my eggs is really only a starting point. But I promised Dr Canada to abstain from the fertility yellow brick road . . . and though I agreed to have my eggs tested (because I WANT to know), there will be no further investigations for quite a while. Yes, I have to go back and get my blood taken on day “21” of my period, so we can know whether I’m actually ovulating those American Idol eggs . . . but that’ll be the end of things for now.

Fertility can become so confusing, so overwhelming, and so panic-inducing after having had chemotherapy. Last summer when I thought I couldn’t have children, that was totally crushing. This past Autumn when the doctor gave me some hope – that was relieving. But one way or another, things are going to work out, and I have faith in that eventuality. Chasing down this information is a good thing: I look forward to learning the results because then, finally, I can plan for the future with a clear picture of the options. But there are times to step back too, and after this upcoming consultation – that’ll be my time to step away from the babies and just focus on here and now.

Maybe you know what it’s like to run this fertility race? If you want to share, please do  – it will help others reading this post who are hoping to learn what comes next.

What was your experience?

And in the meanwhile, have yourself a lovely loved-filled day. See you next week.


Fertility AMH results

Today I received a phone call. The phone call. I’d been expected the used car salesman to ring me up and name his offer on our car. This morning we stopped by the lot, and having checked it over he said, “yes we’re interested in your car, but I need to talk with the boss about pricing. Leave your mobile number with me.” Which we happily did, meaning that today I carried my mobile on my person, whereas normally it’s left in my purse in the back office as I work in the library.

But today it was on me. And when it rang, I nipped into the back to answer it away from the students. Good thing for that because twenty seconds later I was in tears.

Results are in. They’re not great. My eggs are quite depleted with .7 pmol/L (or something like that, I’ve only heard the results, not seen the paper detailing the anti mullerian hormone (AMH) test results). The nurse said she was so sorry to deliver bad news, but the consultant thinks my best option for the future would be egg donation. Meaning, not my eggs.

Good on the .7 for hanging in there, even if that basically classifies me as ‘barren’ – it’s better than zero. “You just need one,” said both my husband and mother.

Anyhow – cue the tears, hang up the phone, start the profanity (a kind of medicine not recommended by professionals, but definitely recommended by me). Quiet utterances of ‘fuck’ interspersed with sobs of disappointment. My poor boss opened the door during the phone conversation and saw that look on my face (the ‘ugly cry’ look of uncontrolled emotion), but he handled things very well. After I sucked up my outburst just long enough to fill him in, again rose the tears and he was a great comfort. Poor fellow! It was my last day working with him, and the Avenue has been such a wonderful experience – leaving on a tearful note really does not represent my time within the library. It’s been all laughs and conversation (plus diligent work habits), even during the chemo months the library has been a place of refuge.

But he responded quite well. Didn’t try to fix anything, just let me go home for a private cry.

And then there was my husband. I called him up thinking ‘can’t share this news over the phone, must relate in person’ so just said: “I don’t feel well and need you to pick me up. Like right now, please.” So he came – but not before running around the flat to change his stained t-shirt and throw on some jeans instead of sweat pants. He thought we were going to the hospital! And when he arrived (I had decided to sit on the ground while waiting, which probably increased his worries), he jumped out of the car, and again I broke into a fit of tears –

“I got the results and they say I can’t have children.”

You should have seen his relief! Relief. I wasn’t sick, we didn’t need to go to the hospital. Considering the panic situations that’d been running through his mind, things were okay.

“That’s fine, we’ll be fine.” And he let me cry a little more.

And we will be fine. Today I’m grieving the loss of those eggs. Ever since flipping through Zsolt’s baby album I imagined having my own little big-headed baby, and now – well, we’ll see. Unlike a cancer diagnosis, I am not filled with fear. Sadness, yes, because there has been a loss. This is a loss. But no fear – instead there’s hope. There are options, there are possibilities, there are opportunities. And when we’re ready, we’ll see what can be done.

For now, I’m grieving. For today. Maybe again a little later. But Zsolt and I both feel that things will be okay. We want a family, so we’ll get a family (Hello! We already are a family, but children would be a wonderful gift).

And until then, there will be adventures. Moving to Canada, trips around the world, chasing careers, getting involved, making a difference, enjoying life. With every year – every bloom of the roses – I’m reminded that things are always beginning, always full of opportunity.

In time we’ll grow our family. For now, we’ll grow ourselves.

An AMH to count my eggs

Six months later and we’re at the baby doctor’s office, waiting for our consultation. Again, we’re back at the same clinic where I was diagnosed, but thankfully – this time – they have put us in a different waiting area. No more having to stare at the door, the room, the memory of where I was first told about cancer. Thank goodness for that.

So. Today’s appointment with the doctor went rather quickly. Apart from waiting (we always wait) for fifty minutes, everything was straightforward. [Zsolt and I now arrive at a doctor’s office, any doctor’s office, and immediately find the best magazines. Then we plop ourselves into some chairs and engage in the waiting. This is a-okay with me for one reason: when I had my emergency, we didn’t wait more than ten minutes. Now that my crisis is over, it’s okay to let others go first.]

Essentially Dr Baby-Maker recommended that I test my Anti-Mullerian Hormone (AMH) which will help ascertain whether I have any eggs left in my ovaries.  And then later on (whether it’s here or in Canada, but most likely Canada) the test can be repeated and we can see what’s happening with the girls. It’s a game of ‘how fertile are you’. Apparently from a blood test this lab can determine the number of eggs in a woman’s body- described as ‘Ovarian reserve’ ranging from optimal fertility, satisfactory fertility, low fertility and very low/undetectable. Boo for very low fertility, and yay for optimal to satisfactory.

Again, there were reassurances not to worry about my lack of menstrual cycle. So, I am trying not to worry – and what’s the point anyhow, now I’m going to take a test that will monitor my level of eggs . . . so whatever mystery exists is soon to be resolved. Tomorrow I’m calling the clinic to arrange for the test. Because it’s new, the test isn’t covered by the NHS, but – obviously – Zsolt and I think it’s worth the reasonable £50 fee.

Speaking very honestly, I’m not keen to have a treatment like IVF – at least, not at this point. Hormones got me into this breast cancer mess, so avoiding a surge of drug induced hormones (more, following eight years of on-and-off birth control and now the estrogen blocking tamoxifem, though that’s a bit different, it still pertains to estrogen) doesn’t feel like a good idea.

Anyhow, I’ve been surprisingly calm about this entire day. Soon Zsolt and I will learn whether I have eggs left in my ovaries. That’s an important thing. And then we’ll get on with our lives (and our family planning), one way or another. 

PS. Zsolt and I followed this visit to the hospital with a visit to the cemetery. We found the resting place of Benny Hill, a British comedian who Zsolt quite admires. If you are ever around the Southampton general, and you’re a fan, it’s worth stopping by to pay respects.

PPS. The weather here is amazing. Today was all sundresses and shades, with a great dose of clear skies and a warm breeze. Perfect for a walk through the cemetery.